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Tips for talking to clients about medicines and prescriptions

The number of complaints to the RCVS Professional Conduct Department from clients regarding medicines is increasing. The majority of these concerns centre on communication and consent.

Medicines cabinetFor example, it is not unusual for an owner to have been regularly administering a medicine to their dog only for them to discover that it is “off licence”, usually because it is a human product that is not authorised for use in dogs.

They may then believe that this would make the medicine unsafe for their pet or have read about adverse reactions caused by the medicine in other pets.

We would advise vets to give a brief, sensible explanation of why this drug has been recommended before prescribing and getting informed consent from the owner, preferably in writing, can save many problems and worries later on.

Ensuring that owners are aware of the medicines you are administering to their pets during consultations is also very important.

For example, explaining that the injection you are about to give is a non-steroidal anti-inflammatory drug before you give it may set their minds at ease or give them the opportunity to ask any questions or discuss any worries that they may have. This will also avoid misunderstandings about what medicine the animal has received and, ultimately, may prevent a concern being raised with the College.

As part of the discussion always try to raise common side effects, warnings and contra-indications with owners before prescribing or administering a medicine. You could also give them a copy of the product leaflet so that they are fully aware of all potential side effects of the medicine.

It is always worth making a brief entry about such a discussion into the animal’s clinical record for future reference.

One thing to note when supplying the product leaflet is that, when they read the various warnings, the owners may see something that worries them or, if there are warnings to “use with care”, they may be anxious about administering the medicine. A discussion with the owner at the time will help with this.

If adverse reactions, either real or perceived, are noted this should be clearly recorded in the client’s records and reported to the Veterinary Medicines Directorate. The obligation on veterinary surgeons to report drug reactions applies to all drugs and is not restricted to those supplied by your practice.

It is also very important that veterinary surgeons remain up-to-date with the summaries of product characteristics (SPCs) for any medicines they are prescribing and make sure they adhere to any of the contra-indications. For example, if it states on the medicine’s contra-indications that it should not, for example, ‘be used in pregnant bitches’ and you have used it in that situation, then it is a difficult clinical decision to justify should complications arise.

Unfortunately, SPCs change regularly – but there are ways in which you can keep track of the latest information. The Veterinary Medicines Directorate, for example, has a product information database that you can search by product name, active substance, class of medicine or species. You can also search by recently updated SPCs.

January 2016